THEODORA PETER Three months after the surprise public decision in favour of a 13th month of OASI (old-age and survivors’ pension) payments, a second sociopolitical shock failed to materialise. Even though many households are creaking under the strain of high health insurance premiums (see “Review” 3/2024), a majority of voters rejected the idea of extending further reductions. The SP’s premium relief initiative would have primarily benefited low-income earners, who currently spend over ten per cent of their income on health insurance. The initiative received widespread support in French-speaking Switzerland and in Ticino, where premiums are higher than in other regions. The German-speaking cantons, however, and thus the majority of voters (55.5 per cent) vetoed the proposal. Opponents of the initiative had stressed during the campaign that the measure would cost billions. The Swiss Abroad supported the Yes camp in vain: they narrowly approved the proposal. The second proposal on healthcare costs submitted to the vote of the people was an even bigger failure. The so-called “Cost brake in the healthcare system” measure was rejected by 62.8 per cent of voters; even the Swiss Abroad were against it. Only five cantons approved the Centre Party’s initiative. The Centre had hoped that these cost brakes would create more pressure to lower costs in reality. A majority of voters were nonetheless concerned that adopting such a scheme could lead to a two-tier healthcare system. Federal Council to state cost targets The failed initiatives have not been entirely for nothing. In both cases, indirect counter-proposals that had previously been approved by parliament come into effect. Cantons that until now had invested only a little in reducing premiums will now have to devote more money to the issue, although considerably less than the initiative would have required. Instead of cutting costs, the Federal Council will now set cost and quality targets every four years for the healthcare sector. This is intended not least to clarify which costs are medically justified. From the perspective of the healthcare economy, this is a step in the right direction, but demographic trends are posing further challenges. The baby boomer generation is now of retirement age, and an ageing population means more costs for doctor’s visits and hospital stays. The people want the best possible care Expensive healthcare remains one of the major financial concerns for the Swiss population. Health insurance premiums have more than doubled in the past 20 years, and a further increase is looming in 2025. The various stakeholders involved were previously unable to agree on which reforms would curb this trend. A new financing model, which would provide greater incentives for outpatient treatment instead of costly hospital stays, is expected Initiatives fail but problems remain On 9 June 2024, Swiss voters rejected two popular initiatives putting forward various solutions for Switzerland’s very high healthcare costs. This unresolved problem will remain something of a political hot potato. Cost reduction initiative 0 5 1015202530354045 50 55 60 65 70 75 80 85 90 95 100 38.2% The Centre’s initiative that aimed at cutting healthcare costs was rejected by a majority of 62.8 per cent. Only five cantons came out in favour of the proposed instrument for regulating rising costs. The Swiss Abroad also rejected the proposal. Swiss Abroad Cost Brake Initiative – yes votes in per cent Premium relief initiative 0 5 1015202530354045 50 55 60 65 70 75 80 85 90 95 100 50.9% The initiative brought by the SP failed to reach a majority: 55.5 per cent of voters and the majority of the cantons said no. A language divide emerged during the vote. Only the French and Italian-speaking cantons supported the drive to cap premiums. The Swiss Abroad also voted yes. Swiss Abroad Premium Relief Initiative – yes votes in per cent Swiss Review / July 2024 / No.4 18 Politics
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